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Dotti Owens, Ada County Coroner

Opioid Overdose Reversal - Ada County Coroner

(Please see https://adacounty.id.gov/coroner for the latest version of this information)

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Opioid Overdose Reversal

An opioid overdose reversal medication is available by prescription from Idaho medical providers or pharmacists

Opioid Overdose Reversal

Naloxone, an opioid overdose reversal medication, is available by prescription from Idaho medical providers or pharmacists.
Opioid overdose is extremely life threatening. Call 911 first. Take efforts with CPR to keep victim breathing so medication has time to work to increase effectiveness.
Any form of this medication is only legal to be possessed by the person whose name is on the prescription. Some insurance companies cover these medications. If you are under probation or parole supervision, please discuss with your supervising officer if you have a prescription.
What is naloxone? It is a medication designed to rapidly reverse opioid overdose. As an opioid antagonist, it binds to opioid receptors and can reverse and block the effects of other opioids. It can very quickly restore normal respiration to a person whose breathing has slowed or stopped from overdosing with heroin or opioid pain medications.
There are three FDA-approved formulations:
Injectable (training required): Generic injectable naloxone vials with syringes.
Prepackaged Nasal Spray Brand name NARCAN® is a prefilled, needle-free device requiring no assembly and is sprayed into one nostril while victim lays on his or her back.
Auto injectable Brand name EVZIO® is a prefilled auto-injection device that makes it easy to inject quickly into the outer thigh. Once activated, the device provides verbal instruction to the user describing how to deliver the medication, similar to automated defibrillators or epi-pens.
How much does naloxone cost?
(As of Jan 2018. Prices may change and vary)
Costs vary depending on where and how you get it. Those with public or private insurance should check to see if it is covered and its co-pay because many insurance companies cover it. There may be no out-of-pocket cost with some insurers.
Those without insurance can check on the retail costs with their local pharmacies. Always ask if discounts, coupons, or an assistance program is available.
Local pharmacy cash prices (quoted January 2018)

Pharmacy NaloxoneHCl NARCAN
Albertson’s / Savon $19.94 $138.00
Costco  *non-members can use pharmacy $54.15 Not in stock
Fred Meyer $30.49 Not in stock
RiteAid *says ask for discount coupon $115.00 $147.00
Shopko *w/ discount card $24.55 $136.00
Walgreen’s $38.00 $130.00

Local pharmacies order EVZIO only upon request.

Cost assistance programs

Kaleo, the maker of EVZIO®, has a cost assistance program for those with financial difficulties and no insurance. More information and forms are available at evzio.com/patient/evzio-savings/ EVZIO’s website states, “All commercially insured patients pay absolutely nothing out of pocket for EVZIO [if they go through the EVZIO direct-delivery service].”
For questions about EVZIO2YOU, call 1-855-77-EVZIO (1-855-773-8946)
NARCAN® website, www.narcan.com/affordability, states “According to IMS Heath, [for those with insurance,] 35% of prescriptions for NARCAN® Nasal Spray have a co-pay of $0 while 75% have a co-pay of $10 or less and almost 80% have a co-pay of $20 or less. For those paying cash, ADAPT Pharma has partnered with retail pharmacies to reduce out of pocket costs.”
In Idaho, friends, family members, and others in the community may administer naloxone to someone who has overdosed. Medical providers or pharmacists can prescribe naloxone. The dose varies depending on the formulation, and sometimes more than one dose is needed to help the person start breathing again. Some prescriptions are for two doses.
Anyone who may have to use naloxone should carefully read the product instructions.

These videos show how to use:

Dr Magni Hamso, Terry Reilly Health Services, demonstrates naloxone and EVZIO® use: www.youtube.com/watch?v=3cDvEjWbzjo
NARCAN® nasal spray use: www.youtube.com/watch?v=hGVSaO1oxpg
A person administered naloxone should be observed constantly until emergency care arrives and for at least 2 hours by medical personnel after last dose of naloxone to make sure breathing does not slow or stop.

Naloxone is not a substitute for medical care!

While it is an extremely safe medication that only has a noticeable effect in people with opioids in their system, naloxone can cause withdrawal symptoms which may be uncomfortable, but are not life-threatening. Withdrawal symptoms may include headache, changes in blood pressure, rapid heart rate, sweating, nausea, vomiting, and/or tremors.

Direct any questions to doctor or pharmacist.

 
Checkout Coroner Owens’ official release document for more information